A Breakthrough in C-Section History: Beatrice of Bourbon’s Survival in 1337

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Beatrice of BourbonCreditNational Library of France

By Hana de Goeij

Nov. 23, 2016

Births by cesarean section are so common these days that it is easy to forget what they were like before the advent of modern medicine: desperate gambits to save a baby by sacrificing the mother.

Cesarean births are mentioned in history and literature going back to antiquity, but the severe pain and stress, loss of blood and likelihood of infection usually added up to a death sentence for the woman, if she was not dead already.

When did all that start to change? When and where did both mother and child first survive a C-section?

Would you have guessed medieval Prague in the winter of 1337?

Neither would most historians, until a team of Czech researchers recently found an apparent case at the court of John the Blind, King of Bohemia and Count of Luxembourg.

John’s second wife (and second cousin), Beatrice of Bourbon, gave birth to her only child, Duke Wenceslaus I, on Feb. 25, 1337. Beatrice, a teenage queen consort, had a pretty rough time of it, according to archival documents turned up by the researchers.

“Beatrice most likely passed out during delivery, and was believed dead,” said one of the researchers, Dr. Antonin Parizek of Charles University in Prague, a noted obstetrician and expert on medical history. “The surgeons opened her only to save and baptize the child. The pain from the operation then likely led to her awakening.”

At that point, he said, shock may have saved her life by keeping her from bleeding excessively.

Prague in the 14th century was a center of European learning, and the royal court of Bohemia would have employed the leading doctors of the time, a best-case scenario for Beatrice to recover from major abdominal surgery. And recover she did, to live 46 more years.

In a Flemish rhyming chronicle that was probably written by a diplomat at the court, the author “did not conceal his astonishment over a procedure when ‘the duke was taken from his mother’s body and the wound healed,’” Dr. Parizek said, adding that other archival sources described Beatrice “being opened up without dying.”

“The event must have been truly uncommon, as information on the medical state of royals was not made public in those times,” Dr. Parizek said. Though the evidence is indirect, he said, it “makes us believe that both the queen and her son survived a cesarean section.”

Before the Czech study, the earliest documented case was in Switzerland in 1500. Some scholars see hints in religious texts that successful C-sections may have been performed as long ago as the second century A.D., using knowledge that was later lost, but Dr. Parizek is skeptical. “It is highly unlikely — there is no evidence,” he said. “I would compare those interpretations to the story of Adam and Eve.”

What about Julius Caesar, for whom the procedure is mistakenly said to have been named? No, historians say, he couldn’t have been born that way — his mother survived.

An illustration with an earlier version of this article was published in error. It depicted Beatrice of Burgundy, Lady of Bourbon and wife of Robert of Clermont, not her granddaughter, Beatrice of Bourbon.

A version of this article appears in print on , on Page A14 of the New York edition with the headline: C-Sections’ Breakthrough in a Medieval Royal Birth. Order Reprints | Today’s Paper | Subscribe